for a very recently infected person (< 6 months), who is 100 meds complient when the time comes, what's the probability of having a strain of virus that is resistent to the meds to an extent that the condition will be life threatening?

Response from Dr. Young

Assuming that the virus that you were infected with is wild type (drug-susceptible) and you really take medications 100%, the likelihood of virologic failure and drug resistance is very, very low. A recent study by Dr. Fischl in Miami showed that 100% of persons who were given their medications by directly observed therapy (DOT) achieved undetectable viral loads after one year. This result was found, independent of the type of medications used.

In the more real world, treatment failure happens in between 75 and 90 percent of the time after one year. In the analysis of the HOPS cohort, Palella and colleagues showed that the median time that someone spends on their first treatment regimen is about 1.5 years. This is not to say that many, many persons are still on their first regimen 4 or 5 years after starting. The goal of clinical research is for all patients to be able to have long-term viral suppression on simple, well-tolerated treatment. Clearly we have more work to do in order to improve our treatment performance. BY

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